Individual provider Active NPI

Stephanie Nuno

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1184342990
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18363 Issued in TX
Practice address
1023 Lipscomb St Ste 200
Fort Worth, TX 76104-3102
Phone
(972) 544-6600
Fax
(972) 544-6604
NPI assigned
Aug 17, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18363 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1023 Lipscomb St Ste 200
Fort Worth, TX 76104-3102

Mailing address

3600 N Edwards St Apt 2216
Midland, TX 79705-5229
Phone (972) 997-5626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241113001603 TX Practitioner - Physician Assistant 2860926813 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Worth Institute of Medical Sciences LLCGroup PAC ID 4688021306, 17 clinicians
Inpatient Physician Associates PLLCGroup PAC ID 1759379092, 30 clinicians

Practice addresses (Care Compare)

1023 Lipscomb St
Suite 201
Fort Worth, TX 76104-3196
Phone (972) 544-6600

6901 Snider PLZ
Suite 130
Dallas, TX 75205-5649
Phone (972) 381-6690

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18363TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Suresh Kankanala M.D, P.a. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1184342990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 N EDWARDS ST APT 2216",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797055229",
            "telephone_number": "972-997-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 LIPSCOMB ST STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043102",
            "telephone_number": "972-544-6600",
            "fax_number": "972-544-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNO",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-17",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18363",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.